- Good evening.

I'm Sonia Gutierrez, journalist with Rocky Mountain PBS.

More than a million people in Colorado have received their first dose of the COVID-19 vaccine.

Some are waiting for appointments and others are voicing concerns about the safety of the vaccine.

There are a lot of questions, we hear them here at Rocky Mountain PBS, and the hospitals and the medical professionals in Colorado are also getting questions every day.

We hope to provide some answers today.

I'm joined by three medical experts from CU Anschutz.

Dr. Ross.

M. Kettle is a professor of Immunology and Microbiology at the University of Colorado, Anschutz Medical Campus.

Kettle is a vaccine technology researcher who has studied vaccines for 25 years and took part in the phase three clinical trial for the Moderna vaccine this past summer.

Dr. Kweku Hazel is a surgical fellow at the CU Anschutz School of Medicine, Kweku is originally from Ghana, and works with local black and Latino communities to address vaccine hesitancy.

Dr. Rosemary Rochford is also a professor at CU Anschutz, with a joint appointment in immunology, microbiology, and environmental occupational health.

Welcome, and thank you all so much for being here with us.

I wanna start with a question for everyone on the panel.

What are some of the biggest vaccine myths and inaccuracies that you'd like to clear up today?

- Great question.

One of the ones I think it's really important, I just got this the other day was the vaccine is experimental.

I'm not gonna take it because it's experimental.

And the answer is absolutely not.

It is not experimental.

We've had vaccine since, we developed the vaccine for smallpox.

So it's hundreds of years, the idea of a vaccine to prevent disease, polio, measles, and so on.

So vaccines are not experimental.

And if we think about the different types of vaccines, we talk about the Moderna, the mRNA, or the J&J, those aren't experimental either, the J&J vaccine, the platform that they use to make this was actually already approved for an Ebola vaccine.

So that's not experimental, the Moderna, mRNA has been studied for 12 years.

And, when we think about the virus SARS-CoV-2, that's a new virus, but we've used the work we've done on SARS and MERS.

And in doing that, we also discovered that that spike protein, which is the target for our SARS-CoV-2, they studied in these other viruses.

And so that information from those viruses were translated to this one.

So definitely not experimental.

They've done Phase One, two, and three, those were the experimental phases, pass through for safety and efficacy all the way through.

So it's not an experimental vaccine.

- I researched about it and one of the other things that comes up often is this was developed too quickly, that it was developed in a way that they can't ensure safety and we get that question an awful lot, and it was clearly expedited.

But there's an awful lot about the process.

That's just complete bureaucracy.

One is limited by the biology of immunity, that takes a certain amount of time to develop.

But then the rest of it is all manufacturing and bureaucratic problems.

And it is possible to streamline all of those things, and actually have a functioning successful vaccine, multiple functioning, successful vaccines, less than a year after the infectious agent was defined, which this is absolutely world record speed.

But we get the question is, how is it possible this was done safely and it absolutely would follow the proper safety measure.

So emphasize that point as well.

- Interesting.

So we're not reinventing the wheel and if you eliminate a lot of that bureaucracy and all those steps, it is possible to do go-- - Yeah something that I've mentioned before is that, you know, people talk about the last vaccine that was, the last fastest vaccine took four years, and it was the mumps vaccine, but it was 19, late 1960s.

- Changed a little bit since then.

- We do a lot of things faster since the 1960s.

So you know, I think we can go with that.

- [Sonia] Interested to you or yet?

- Yeah, those are very great points.

Another question I do get is can you get the disease COVID-19?

Can you get the disease or the infection from the vaccine?

And the answer, the short answer is no.

The way these vaccines are developed, they do not contain any live viruses whatsoever.

And so these vaccines cannot cause you to have COVID-19, the infection or the disease.

You can get infected before you get the vaccine and to a much lesser extent you can get an infection after you get the vaccine.

It is very mild.

And we believe the vaccines do help prevent serious disease and death.

We actually pretty sure of that.

So the answer I typically give to most people who asked that question is no and the vaccines actually very safe and do not give you an infection.

- That's a really good point.

I have heard that from several people who are hesitant about the vaccine.

It's like, well, oh, it's being injected into my body.

But we hear that no, that's not the case at all.

So thank you all so much.

So, Ross and Rosemary, both took part in separate clinical trials and have first hand experience.

Can you briefly explain the difference in the technologies behind the approved vaccines?

How does the Johnson and Johnson differ from Moderna also?

- [Rosemary] I'll let Ross, take that.

- So I'll discuss the trial, I was part of which was Moderna.

And then maybe you can talk about the J&J and the platform differences, maybe that's a good way to do it.

So the Moderna trial is very similar to the Pfizer vaccine.

They're made out of mRNA, which, if you go back to high school biology, DNA makes RNA and RNA makes protein, right.

So the RNA is injected in the vaccine, and it essentially turns your muscle into a vaccine factory, it allows your muscle to make the protein against which you want the immune response to react.

So rather than making the protein in the factory somewhere, it just creates the information for that protein and then allows each individual to become their own, essentially their own vaccine factory.

And it turns out, this is an incredibly potent way of making immunity.

These vaccines have been around, this kind of an idea has been around for a while, DNA vaccines have been used, but they've never been anywhere near as good as these mRNA vaccines.

And there's some inside baseball as to why that is that I won't get into but suffice it to say this, it turns out to be a very, very powerful way to generate immunity.

So in the phase three part of things I heard it was on campus, and I was just very excited to be part of it as someone who studied vaccines for 20 years.

It's rare to get a chance to be part of a trial of any kind.

And so it was it was exciting to sign up and to get in.

And then of course, the next step is did you get the placebo or did you get the vaccine, and within about five hours of getting immunized, my arm started to hurt.

And so I knew, okay, I'm pretty sure I got the vaccine.

And I have a certain set of skills.

So I was able to track my immunity all the way throughout the vaccine process, as well as actually Rose as we, together we created a new test to monitor antibodies against the vaccine.

So we've been following our own immunity as we've gone through.

So it's been, that's been very exciting.

But anyway, that's the Moderna version of things and you can say what the J&J versions.

- And the J&J, or Johnson and Johnson vaccine, I would like to just shorthand it is the same idea so, the virus has a spike protein on the outside of it.

And that's what it binds to get inside the cell.

So the goal is you wanna make antibodies to prevent that spike protein in.

So you wanna give the body the spike protein.

So either you give it as a messenger RNA to make the protein or in the J&J, what you do is they take a shell of a virus, that there's just the outer code of it to allow it to get inside, it gets inside the cell and delivers that information for the spike protein, again, turns your cells into a little factory to start making that spike protein.

So that your body sees gets that danger signal and makes the antibodies and the T cell responses against that.

So very similar in the sense that they're both targeting the same part of the virus, actually, all the vaccines target that spike protein, they're all the same.

They realized, like I said, from the earlier studies, that that's the key piece, if you can keep that virus from getting inside the cell with those antibodies, and that's the spike protein, then we're golden, right?

That's the target.

It's just the different ways these different vaccines try to get the body to make antibodies against the spike protein.

So a little variation in that as well.

- I had never heard it explained like that.

And that actually makes a lot of sense and reassuring.

Thank you so much.

So here's another question for everyone.

Can people mix vaccines, for example, give a first dose of Modera and a second dose of Pfizer?

Does it impact the effectiveness at all?

Or does it make it more effective?

I mean, what does it do?

- I'm gonna jump in right with that and the answer is it probably, at some point we'll have the answer to that question.

But we haven't done those tests yet to answer that.

So if you get the Moderna vaccine, you should stick with the Moderna, if you get the Pfizer stick with the Pfizer, get the J&J stick with the J&J until we've done the test on people and say, Oh, if I give you a Moderna and then I give you Pfizer, what does that do?

Or vice versa?

But we don't have the answer to that yet.

I would say though, probably it's gonna be fine, just based on what I know of immunology, but I would not recommend it until we get to that point.

- Yeah, and actually, those tests are being done right now in Great Britain.

So they're studying combining the Pfizer vaccine and the AstraZeneca vaccine.

And in various, you know, one first and then the other thing the other way around.

This is a process that immunology has been, we've been playing with in lab for the last 25 years.

And it works in, it always works better to mix vaccines than it does to use the same vaccine.

So and that's actually been tried in clinical trials against Ebola virus as well as HIV.

So in the DNA vaccine and the viral vector vaccine, so this idea of mixing vaccines.

This has been done and all the data we have says that it's actually better than single vaccine platforms.

That said, we have yet to test it with the Coronavirus vaccines, I would be willing to bet an awful lot that once we do so things are actually gonna be much better, but time will tell.

- But for now stick to get the first one, just complete that process.

- That's what the CDC recommends right now.

- Okay, interesting.

That's good to know.

So despite the reassurances in the news, debate continues about vaccine hesitancy in general, but specifically in the black and Latino communities.

Kweku, can you tell us some of the historical reasons behind that hesitancy?

- Yes, that's a great question.

So first of all, think vaccine hesitancy in and of itself, have kind of that word places the burden on the communities that are affected.

So I have a little bit of an issue with the word or the term vaccine hesitancy.

Really, what it's referring to is when people and either people of color and minority communities, like you said, have an aversion of some sort to receiving the vaccine.

And so, when I'm thinking of this, for my behavioral health standpoint, not only should we place the burden of behavior change on these communities, but also the communities that or the systems that perpetuate this or cause these hesitancies to happen, should also be changed at the same time.

And when you use vaccine hesitancy, the focus just goes on to-- - [Sonia] The community.

- The communities being affected.

- That's a really good.

- So in light of that I can talk about, a little bit about the historical context.

As everybody's aware, here in this country, there's been a history of unfair medical practices, especially with research and medicine, with regards to minority communities, for example, the Tuskegee syphilis experiment that was held in the 19th century.

And also, we all know about the story of Henrietta Lacks.

And so, these are well documented, they are even movies about them.

Most or some of us are taught about this in school.

And if you want to learn it, it is very easy to really be able to find this information and learn about them.

But equally as important to the historical perspective is everyday experiences of people of color.

And I found out that, that has equally if not more of an effect on their decisions when interacting with science or the medical system.

So the stories people hear from their family members, their community members, current stories and and their current experiences.

You know, just recently there was this physician, Dr. Susan Moore, who essentially was a black physician, had the COVID-19 disease and was in the hospital, and felt like her concerns weren't being addressed.

She felt like she was being treated like an addict and she wasn't being listened to, she eventually did pass away, but not after posting a video describing her experience.

So this is real, and it's happening right now and that plays a part in how the hesitancy is being perpetrated around these communities.

So while focusing on trying to change behaviors in the minority communities to help address hesitancy, we also need to focus on the systems that are perpetuating this.

- And what can like these systems do, because you're right, like when you, even the way we formed the question that already places that burden of responsibility in a community that everyday lives such an experience that tells them to be, you know, these feelings don't come out of nowhere, you know, even me, I come from an immigrant family, I went to clinics with my mom, she got the wrong procedures that led to worst conditions, you know, like, these are things we live firsthand.

How do you get past that shadow, you know of that lives with you, that it's firsthand and on the community side, but also, you know, systems do have a responsibility to address that.

- Exactly.

- And to make sure that if we're gonna get through it as a community that we are sensitive to the needs of everyone in the community.

- Absolutely, that's a great question.

And it's difficult.

It's extremely difficult.

But what I do, I could speak to what I do, and I don't think anyone has the answer for sure.

I think it's a learning process as we move on.

It's something that's existed for a long time.

And if we knew the immediate solution, we would have been able to fix it, but what we are doing is learning.

And so first of all, what I do is listen, listen to the communities, listen to their concerns, validate them, say, Hey, your concerns, the reason for your hesitancy are valid and understand them, and then educate, you educate them, but also reassure them that at the same time we are working on these systems or the, whatever is perpetuating these hesitancies, we're working on them.

So for example, increasing minority representation in research, in health care, you know, those are the kind of things that will help change those systems, while at the same time talking, communicating, validating, and educating these communities that are affected, and helping.

So it's a two prong approach that helps you get through this problem.

- Yeah, and only together.

- Yes.

- Yeah.

- Can I ask what term would you use?

I'd love to be educated.

Instead of vaccine hesitancy because as a vaccinologists we absolutely kick that around way too much, it turns out.

So what's vaccine distrust?

What do you use?

- Honestly, I don't have an answer for that, because I haven't thought about another term that is going to be able to describe it.

But, what I can say is, we should think of a term that doesn't place the burden on those being affected by this problem.

And that is the core of it.

So any term that could share the responsibility will be probably a better description of the problem.

- It's a fundamentally a trust problem, which, yes, two sides to this thing.

And absolutely, you know, we need to take responsibility for that.

- [Kweku] Absolutely.

- That's well said.

- Or even when if and when we use that, make sure that we also address that.

And it's not just on this side of the community.

Thank you so much for that.

So the irony of course, of this is that black and Latino residents are often at the highest risk of getting COVID-19.

So can you all talk about some of the historical health inequalities that lie behind this high risk?

- I'll start with that.

I mean, if we think about this, from the inequalities, it's not just health inequalities, it's inequalities.

And a virus doesn't understand any of those things but it exploits the vulnerabilities that are there.

So from the exposure, the first thing, who's exposed to the virus, right?

So we think about that.

If you live in a crowded conditions, you're gonna have more chance of exposure.

If you take public transportation, you have more chance of exposure, then you can think about infection, what are the conditions that allows you then to be infected, you can think about who's more susceptible to disease, and that lack of access to health care, lack of insurance affect sort of the sum of those transitions, lack of just trusted information to find out what should I do, right?

Should I go with, my breathing is down, should I get a pulse oximeter?

When do I think it's serious enough, been discarded, not discarded.

Being, people not sort of taking you for, seriously, right?

So I'm not being able to breathe, don't worry about it go home, right.

So all of those coming back to your point about how we minimize maybe some people's problems.

So it's a lot of different places where the virus can take advantage of that, if I could say it so bluntly.

And we know in this two to three times more likely, people of color are likely to be hospitalized and two to three times more likely to die, have some more to morbidity and mortality.

If we think about it our Native American communities, access to health care is a huge problem for those communities, and it's resulted in higher morbidity and mortality in those populations.

- Yeah, I definitely second that.

And I'd add to some of the reasons are the social determinants of health.

So what does that mean?

That is referring to anything in the community, or the lives of people that affect them outside the pathogens, so for example, the place they live, the air they breathe, the access they have to medical resources, their socio-economic status, all of these play into their social determinants of health.

So those things are what really have been driving these disparities in our communities, for example, living in food deserts, you know and then not being able to and even the mistrust of the healthcare system not having access to education, poor socio-economic situation.

So those are some of the barriers that lead to these health disparities and these conditions that make COVID-19 the pandemic more significant in these communities of color.

- Yeah, you're right, and sometimes even fear of these systems to mistrust and depending on the community, sometimes fear of going to any kind of, you know, system like that.

But thank you so much.

Did you have anything to add?

- I have no reliable opinions on this topic.

I'm learning a lot.

So, I'll be silent and thoughtful and rather than speak and remove all doubt.

- So we see lots of percentages surrounding these vaccines in terms of effectiveness, 60% here, 94% there.

Ross, what number should people be focusing on to be less confused and more assured?

- Yeah, so some of these numbers issues comes, to me it anyway, it comes back to the misconceptions about exactly what do vaccines do?

What are the various roles vaccines have?

A decent vaccine will actually just simply prevent a really severe consequence of an infection.

So the BCG vaccine, I think, is a good example.

Kids all around the world, outside of the US get the vaccine and that's against tuberculosis, it doesn't actually stop tuberculosis, but it stops neurological complications in kids for tuberculosis.

And even though it doesn't prevent tuberculosis, we actually rely heavily on that vaccine, it's considered a very good vaccine.

So the next level is a vaccine that really prevents any significant or you know, severe disease or hospitalization, that's a very good, a great vaccine.

The second level, the next level is one that just stops infection, completely, that blocks infection and blocks transmission.

All of these vaccines that we're dealing with fully occupy the first two categories, they really restrict completely severe complications from infection.

And there's extremely good and growing evidence that they also do a very good job blocking infection and transmission.

So, the percentages are sort of quibbling about exactly how much if you get infected after vaccination, how much you may or may not feel sick, every single one of them keeps you out of the hospital, though, and keeps you away from dying.

So in that sense, they're all across the board, very, very good vaccines.

So getting getting too hung up on the numbers, at least at this stage of the game is not really what you want.

Grab the vaccine you can, I actually kind of wished I'd gotten the J&J vaccine.

It's a vaccine that makes better T-cell, is single shot, it makes better T cell responses than the vaccine I got.

And I'm kind of a T cell guy.

So I showed a wish and there's some evidence that I think that will come out that the durability of that maybe you have some advantages of a Moderna.

So we have so much to learn that at the moment, getting super hung up on these percentages is really not your best bet, get a vaccine, get it as quick as you can.

The only way out of this mess is through vaccination.

- Just, don't even think about the numbers, just go get the vaccine.

- There are people whose job it is to have, whose job description is to have thought deeply about those numbers.

And they have vetted them very, very carefully.

And I do trust.

And again, maybe this is back to our previous conversation, I trust in those numbers and those organizations.

And maybe that's part of the the catch here is inspiring that same trust in the BIPOC community.

But, given my profession and what I've seen and been through, I trust the people who vetted those numbers very carefully.

So grab the vaccine as quick as you can.

- Got you.

My husband always says that he's like, someone already did that job for me.

(laughing) I have something else to worry about and that's to get the vaccine.

- Yeah, exactly, good, exactly.

And I'll do my take.

- So COVID variants seem to be all over the news.

What is the latest information each of you have?

And what do people need to know about how the vaccines will protect them?

- I'll take that one.

- Yeah.

- Yeah, so I'm just back, I'm a virologist.

So I'd like to explain the virus.

So when we think about variants, what does that mean, where did they come from?

When the virus gets inside the cell, it has to make copies of itself and it makes 1000 copies and to make those copies to make more nucleic acid, it uses a protein called a polymerase.

But it's a really sloppy copier.

So what makes mistake, so it's making 1000 copies and it makes errors as it's doing it.

The virus doesn't care because when it gets back out, oh, it only needs one more cell buyers to get into another cell, right.

So what happens is the virus uses this strategy to kind of improve its infect ability over time.

So virus gets inside the cell and an individual person gets inside one cell makes 1000 new viruses, some of them are good, some of them are nuts, some might be a little bit better.

And that better virus then gets into more cells and more cells, and then you go and you spread it to the next person and they get that new variant, right?

And it makes it more transmissible.

So we know that there's variants, that's the nature of this particular virus.

It's got a bad copy machine, so it's gonna be making variants.

Yet, there's a few that have come in around, Colorado has 20% right now, I think we just announced for CDPHP have a variant from California.

So that's sort of becoming dominant.

There's ones, and they're described from where they've emerged from, but it has no, they might also emerge from here as well, because they're gonna be coming up.

So they're here, the vaccines, as we know of right now are still protective.

It's one of the things, I call it a numbers game, we wanna all get vaccinated.

So those viruses get inside us, they don't have a chance to make new versions and get out to somebody else and cause more trouble.

So the better we all get vaccinated, the sooner we can keep this virus from popping out new versions of itself.

And I think that's really the important measures, the virus is gonna be trying to do it, we're trying to not have it do it.

So the win is for us to basically stop it from replicating and making bad copies that are gonna cause us trouble.

- It's a bit of an arms race.

- That's what I was gonna say, yeah, it's like a race and we will win, if we all get vaccinated.

- If we all get vaccinated - So far, the vaccines are the only reliable way to protect against them.

And so that's our advantage for the time being, we could lose that advantage if there is a really slow rollout in here, so.

- Got you.

I wanna end quickly on one note.

Resources, support, help that community should know?

Any last thoughts that you really want people to walk away with?

- I can start with this.

So that's a great question.

And in terms of resources, when we, there are numerous educational seminars happening around the state with regards to educating people about the pandemic and also about the vaccines and the CDPHP website and then Immunize Colorado has more information on this.

In addition to this, after people get convinced or make the decision that they're gonna get the vaccine, then where do you get it, that's the next level of access.

And so in providing access, especially starting with communities of color, the state has teamed up with multiple organizations, including my wife, Cynthia Hazel, who is a doctor of Public Health at Omni Institute, and I who are doing pop up clinics here in the Denver Metro area, to help provide access or bridge this access gap.

So these are some of the resources your physician's office, local pharmacies, these are all places in which when you make the decision to get the vaccine, and it's your turn, you can go to and get in line.

- I'll give Rose the last word here and jump in real quick.

The two things I would say is the trust issue, I think, I've been reminded of that, that the trust with the medical community and with vaccines in general has really waned over the years.

And so I'm hopeful that the fact that two of us were really comfortable enough to jump in at the experimental phase of a couple of different vaccines because of our confidence in the process and our confidence in the strength of these vaccines, that we're not just sitting here telling other people what to do, but we were willing to kind of put ourselves on the line.

In a sense, I'm hopeful that that helps inspire some trust, I hope that'd be helpful.

And then secondarily, really the only way out of this is through vaccination.

There's never been an infectious disease in the history of humankind, that petered itself out because so many people got infected by it, you can't get herd immunity by natural processes.

It's only ever been accomplished by vaccination.

So getting people in the mindset that this is an trusting that this is the way forward, that's actually a really huge priority for us.

- My last point is, I was thinking about a phrase but to support your community get your immunity.

So that's my, my kind of.

(laughing) - I like that.

I like that-- - [Ross] We need T-shirts.

- What a way to end us.

- Nice.

- Very nice end.

- Its very nice, well done.

- Thank you all so much for your time, for your input.

We hope that this panel helped answer some of your questions.

And if not reach out to us.

We'll be happy to help connect to resources.

Remember, we can always count, you can always count on Rocky Mountain PBS.

We hope you all stay safe as we all get through this together.

Thank you so much.